Photo by Anne Rayner

Live, work, play safely

Published on March 4th, 2020 by Christina Echegaray.

High school friends can be a repository of information: from favorite foods and most recent crushes to goals for the future, biggest fears and even how to use an Automated External Defibrillator (AED).

The last item on the list proved to be a matter of life and death for Brooke Kowalkowski, 17, who was diagnosed with Long QT syndrome, a heart rhythm condition that can potentially cause fast, erratic heartbeats that can trigger a sudden fainting spell or seizure. In some cases, the prolonged, irregular heartbeat can cause sudden death.

Luckily, the Spring Hill, Tennessee, teen has not been reluctant to share her condition with friends and teach them about the family’s AED, a portable electronic device that when properly applied can stabilize potentially life-threatening heart rhythms, including sudden cardiac arrest.

While at the neighborhood pool on May 22, 2019, Brooke began having trouble breathing and passed out. Her friends were alert to the situation and called her mom.

“I told them instantly to call 911,” recalled Sandy Kowalkowski, who was not home. “The second thing I said was that someone needed to run to the house and grab our AED and get back to the pool. 

“While someone went to get the AED, a gentleman noticed what was happening and began to do compressions and another woman assisted him. By then the kids had returned with the AED.”

According to Brooke, a friend used the AED to shock her daughter twice. Once the EMS arrived, Brooke received additional shocks and continued chest compressions. After a faint pulse was detected, she was intubated, taken to a local hospital and then transported to Monroe Carell Jr. Children’s Hospital at Vanderbilt.

“Through the years, all of our kids’ friends have known what an AED is and where we keep it,” said Kowalkowski. “We have always tried to educate and raise awareness the best that we could.”

During Brooke’s two-week recovery at the hospital the family began discussing the importance of educating the community at large about AEDs and training to properly use the device.

They were not aware that Children’s Hospital was steps ahead of them. Since 2017, Children’s Hospital has been an affiliate of Project ADAM (Automated Defibrillators in Adam’s Memory), a national organization committed to preventing sudden cardiac arrest in children and teens through advocacy, education and preparedness. The free program works with schools and communities throughout the region to ensure they are not only equipped with AEDs but also trained in prevention measures.

Project ADAM Middle Tennessee is one of several programs supported by Children’s Hospital that reaches beyond the walls of the facility to meet patients and families where they live, work and play in an effort to provide useful, sustainable tools for a healthier community.

And it’s working, according to Project ADAM’s medical director, English Flack, MD, assistant professor of Pediatric Cardiology.

“The program has been much more successful than what I thought it would be,” admitted Flack. “It has a lot to do with the enthusiasm that the schools have brought to it. We have reached more schools, teachers, coaches and students than I imagined. We want to empower people in the community that they can save a life. AEDs are not 100%, but they are another tool to assist in a person’s chances of survival.”

For Flack, meeting survivors saved by AEDs is all the evidence she needs to know that Project ADAM Middle Tennessee is making a difference. To date, the program has teamed up with 41 counties, and both public and private schools.

Tennessee law mandates that all public schools provide at least one AED on the property. It recently updated the legislation becoming the only state in the country to require all schools with AEDs to conduct an annual CPR and AED drill and training to evaluate the school’s preparedness.  

Angel Carter, RN, program coordinator for Project ADAM, is a hands-on partner with area schools to help them achieve the Heart Safe School status. Once a school or community center has demonstrated the implementation of a thorough AED program, including ongoing AED maintenance checks, establishment of a response plan, including a designated and trained response team, and a successful AED drill has been completed, they are designated as a Heart Safe School. She also works with youth athletic recreational leagues and community centers to provide education on AED use and CPR training.

“Our primary mission is to help schools prepare for a cardiac emergency on their campus,” said Carter. “It’s all about providing an appropriate response to a cardiac emergency. We know the importance of receiving aid within minutes of an event.”

Data from the American Heart Association shows the incidence of non-hospital related cardiac arrest is greater than 350,000 per year. Estimates suggest that approximately 7,000 of those victims are younger than 18 years old. 

“The average survival rate is less than 11%,” said Carter. “It is critical that a patient get CPR and have an AED used within three to five minutes of their event to potentially double or triple their chances of survival.

“Survival rates decrease by 10% with each minute of delayed defibrillation,” Carter added.

Brooke is now a senior at Summit High School in Spring Hill, Tennessee, and is doing well. Her family recently held a neighborhood AED education event that attracted local medical personnel and members of Project ADAM.

“Brooke is a great example of how we want to branch out beyond the hospital, beyond the school setting,” said Flack. “It’s an extension of where we want Project ADAM to go in terms of awareness. It’s an example of how expanding health initiatives can impact the community at large.”

– by Jessica Pasley